ArticleNature communications2026
Hierarchical dynamic model for risk-stratified screening of nasopharyngeal carcinoma.
Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Early detection of nasopharyngeal carcinoma through Epstein-Barr virus serology is hampered by a low positive predictive value. This study aims to develop a hierarchical dynamic model to refine risk stratification among individuals initially identified as medium- or high-risk by Epstein-Barr virus serology. By integrating longitudinal Epstein-Barr virus antibody data with age, sex, and family history, the model is trained using data from the PRO-NPC-001 program. In the validation cohort, the high-risk model using one-year data achieves a positive predictive value of 18.2% (about a fourfold increase over serology screening), with a negative predictive value of 97.7% and an area under the curve of 0.783. With two-year data, the positive predictive values for the high-risk and medium-risk models are 8.8% and 1.1%, respectively, with area under the curve values of 0.859 and 0.687. Compared with serology-only screening, the hierarchical dynamic models reduce the need for follow-up examinations by 74.2% in high-risk individuals, yielding cost savings of up to 65.6%. These findings demonstrate that hierarchical dynamic models significantly enhance current serological screening strategies for nasopharyngeal carcinoma, though further prospective validation is warranted.
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